This Phase I STTR application seeks support for research to enhance the commercial viability of a tool to assess the cultural competence of health care organizations. The Cultural-competency Organizational Assessment - 360 (COA360) is a web-based tool to measure the cultural competence of healthcare organizations. Major changes in the regulatory environment for US-based healthcare organizations will influence increased use of tools such as the COA360 in the coming years. As the first web-based tool to the market and with a strong brand association with Johns Hopkins, a venerable institution within the healthcare industry, we have begun to gain acceptance in the marketplace. We are well-positioned to be among the dominant products as this market develops. During our previous STTR Phase I project (grant number 1R41MD5172-1), we had extensive interaction with end users. This interaction led to the conclusion that we needed to make certain modifications to our strategy and create a companion product before moving to Phase II and on to full commercialization. We reached this determination after consultation with project officers at NIMHD. Accordingly, this application seeks support for research to establish the technical/scientific merit and feasibility of the new companion product for the COA360. This new companion product is the COA360H (Cultural-competency Organizational Assessment - 360, Hospital Version). The original version of the COA360 assesses the cultural competency of units of a healthcare organization, such as a department, or service. It does NOT assess individuals nor does it assess the healthcare organization as a whole. Thus, in order to obtain an assessment of the overall organization one would need to conduct numerous assessments within one organization (representing multiple departments). To do this would be costly and there would be a significant time burden on hospital staff and patients. During our previous study, end users reported a great deal of satisfaction with the tool (see the Preliminary Studies/Progress Report section below), but there was very strong desire among the end users that we create a second tool that provides a big picture view of the overall organization. This would give user the ability to choose which product was most appropriate for their needs. As a result of this advice we modified the COA360 by adding new questions and deleting others to create two compatible versions of the COA360: (1) The COA360U, which is the currently existing tool that assess a subunit of an organization; and (2) the COA360H, which is the hospital- wide assessment tool. Used in tandem, the COA360U and the COA360H will provide a thorough assessment of a healthcare organization. This suite of products is also responsive to needs defined by the market, which enhances the likelihood of its commercial viability. Thus, this application seeks support to conduct a user experience survey and develop the online application and manual for the COA360H and is not duplicative of our previous STTR grant. In Phase II of STTR funding we will propose to: (1) develop an intervention website for the COA360 system. This will involve the development of a web-based tool to deliver evidence-based interventions to help healthcare organizations improve their ability to meet the needs of the increasingly diverse U.S. population; (2) enroll a set of healthcare units into a study to determine if exposure to the intervention can improve cultural competency; (3) make additional enhancements to the system including (translating the COA360 into other languages, incorporate enhanced online help into the web-based system, and write a manual for the hospital point of contact). This application seeks to address two specific aims for Phase I of the STTR: Specific Aim 1: to conduct a systematic evaluation of the user experience using the COA360H. Specific Aim 2: to conduct a systematic evaluation of the efficacy of the COA360H report content and format.